Kelly Kennedy, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4194-26 Issued in WI

Practice address

N4901 Dam Rd
Delavan, WI 53115-2927

Phone

(262) 740-2170

NPI assigned

Mar 19, 2007

Last updated

Sep 6, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1174647689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W9623 WALWORTH WOODS RD",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531152438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N4901 DAM RD",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531152927",
            "telephone_number": "262-740-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VT",
            "license": "0720000540",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4194-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tesalia R Jordens, D.O.
• Jennifer A Junghen, APRN, DNP
• Shelby Marilyn Marie Kallio-Crotteau, PTA
• Radley Nathan Kamps
• Rachel Karras
• Erin Toireasa Kilkenny, LPN
• Patricia A Kirley, OTR
• Marcia Joan Kooiman
• David Lee Kuntz, D.C.
• Linnea Kurowski, PT, DPT

• Occupational Therapist in Delavan, WI
• Providers in Delavan, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.